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House workforce resolutions emphasize dentist’s role as team leader

Two hours of lively testimony precedes vote

House workforce resolutions emphasize dentist’s role as team leader
Dr. Stephen Glenn: Dr. Glenn, chair of the Council on Dental Practice, speaks Oct. 10 during the Reference Committee on Dental Workforce hearing.

Orlando, Fla.—The 2010 House of Delegates adopted workforce resolutions that stress the importance of the dentist’s role as the leader of the dental team and rescind the ADA’s policy that opposed pilot programs.

Workforce issues took center stage at annual session this year, with a special reference committee convened to consider workforce resolutions.

There were more than two hours of lively testimony on the issue before four resolutions were met with large support from the House.

The issue culminated at annual session after years of work by various ADA councils, webinars and conference calls dedicated to educating volunteers and state leaders about the issue, and a July conference held at ADA Headquarters to share ideas.

“We just really wanted to frame the issue for the House of Delegates, and we tried to represent all of our members and that was the really daunting and hard task,” said Dr. Chris Larsen, chair of the Council on Dental Practice’s Subcommittee on Workforce Issues.

The workforce issue has centered on the efforts of some state legislatures to create a midlevel provider both within and outside of the dental team. Models or pilot programs have been proposed in various states, and different groups and foundations are lobbying legislators to support the position in other states.

Dr. Graham, of Teaneck, N.J.
Dr. Frank Graham: Dr. Graham, of Teaneck, N.J., offers his opinion during the dental workforce hearing.
Resolution 46H-2010, which amended the ADA policy on Diagnosis or Performance of Irreversible Dental Procedures by Nondentists, states “the American Dental Association by all appropriate means strive to maintain the highest quality of oral health care by maintaining that the dentist be the health care provider that performs examinations/evaluations, diagnoses and treatment planning.” The resolution goes on to say that “the dentist be the health care provider that performs surgical/irreversible procedures” and “that surgical procedures be defined as the cutting or removal of hard or soft tissue.”

“The House put an exclamation point on their thoughts in regards to surgical and irreversible procedures,” Dr. Larsen said.

Resolution 92H-2010, which amended the policy Opposition to Pilot Programs Which Allow Nondentists to Diagnose Dental Needs or Perform Irreversible Procedures, states that “if a pilot program involves a new member of the dental team, the new team member must be supervised by a dentist.” It also reads, “that the ADA may support pilot programs that do not jeopardize the patient’s oral health, is based on a valid assessment demonstration that the program is necessary to fulfill an unmet need and the program does not allow a nondentist to diagnose, treatment plan or perform irreversible/surgical procedures.”

The House also passed language related to the education and training of the dental team in Res. 132H-2010, which amended the Comprehensive Policy Statement on Allied Dental Personnel. A revised section states “licensed or legally permitted dentists must be involved in the clinical supervision of allied dental personnel education programs, in accordance with state law. Programs should be administered or directed by a dentist whenever possible.”

The House changed language to say that neither the dental hygiene education curriculum nor the expanded function education programs provide adequate preparation to enable graduates to provide comprehensive oral health care or to practice without the supervision of a dentist. New language states that “the unauthorized and improperly supervised delivery of care by allied dental personnel is opposed by the American Dental Association.”

The ADA’s Department of State Government Affairs anticipates legislation that will challenge current workforce issues will be filed in up to 30 states in the next legislative session.

To read the full text of the resolutions, members can visit the House of Delegates Web page on

Reference committee members listen to testimony Oct. 10 in Orlando.
Workforce panel: Reference committee members listen to testimony Oct. 10 in Orlando. From left are Dr. Gary Yonemoto; Dr. Kevin Doring, committee chair; and Dr. Michael Zakula.